- 期刊
The Effectiveness of Chest Ultrasonography in Differentiating Empyema from Simple Parapneumonic Effusion
胸腔超音波在鑑別單純肺炎旁積液和膿胸的實用性
摘要
目的：探討胸腔超音波是否可以準確區別膿胸和單純肺炎旁積液。 方法：從2000年1月到2007年8月，我們回朔性的收集有肺炎合併積水並且住到彰化基督教醫院小兒加護病房的病人。每個病人都經由胸腔X光片和超音波診斷肺炎合併積水，而接受靜脈抗生素注射後24小時仍持續發燒超過380℃或呼吸困難是我們放置引流管的條件。所有收集的病人的胸腔超音波檢查皆在放置管前24小時內實行。最後我們收集了相關的檢查結果並加以分析。 結果：本研究共收集58個病人，在小兒加護病房中若是胸腔超音波看到漂浮的纖維組織或隔間對診斷膿胸有很高的特異性(92%)和陽性預測值(92.5%)。而它們的敏感性(75.7%)和陰性預測值(74.1%)也都很好。 結論：在臨床上利用胸腔超音波是否有看到漂浮的纖維組織或隔間來判斷是否為膿胸是合理的做法。而依照胸腔超音波的結果來判斷此病人的治療策略是可行的。
並列摘要
Objective: To retrospectively evaluate the effectiveness of chest ultrasonography in differentiating empyema from simple parapneumonic effusion in children. Materials and Methods: We retrospectively studied pediatric patients with a diagnosis of pneumonia with pleural effusion who had undergone thoracocentesis from January 2000 to August 2007 at the Changhua Christian Hospital, Taiwan. The diagnosis of pneumonia with pleural effusion was based on chest X-ray and ultrasonographic findings. Indications for pleural drainage included persistent high-grade fever (＞38℃) for more than 24 hr after parenteral antibiotic treatment or respiratory distress. Pleural effusion was drained via pigtail catheter within 24 hr after ultrasonic examination. All related laboratory data were recorded. Results: A total of 58 patients were studied. The presence of fibrins or septations on ultrasonographic images has a high specificity (92%; 23/25) and positive predictive value (92.5%; 25/27) for differentiating between empyema and simple parapneumonic effusion in pediatric patients in the ICU. The sensitivity of the presence of those abnormalities in differentiating between empyema and simple parapneumonic effusion is moderate (75.7%; 25/33). Conclusion: Fibrin formations or septations identified on chest ultrasonography are highly predictive of the presence of empyema. The clinical doctor handles the aspect of parapneumonic effusion to use sonography is practice and reasonable.
延伸閱讀
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